World Journal of Pharmaceutical Research SJIF Impact Factor 7.523

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1 SJIF Impact Factor Volume 6, Issue 2, Case Report ISSN A CASE REPORT EFFICACY OF NAVAKARSHIK BASTI IN THE MANAGEMENT OF VATARAKTA WITH SPECIAL REFERENCE TO GOUT *Dr. Preeti S. Mangulkar and Dr. Raman R. Ghungaralekar PG Scholar Final year HOD & Professer of Kayachikitsa Kayachikitsa Department Department R A Podar Medical (Ayu) college R A Podar Medical (Ayu) College Worli, Mumbai. Worli, Mumbai. Article Received on 11 Dec. 2016, Revised on 01 Jan. 2016, Accepted on 22 Jan DOI: /wjpr *Corresponding Author Dr. Preeti S. Mangulkar PG Scholar Final year HOD & Professer of Kayachikitsa Kayachikitsa Department Department R A Podar Medical (Ayu) college R A Podar Medical (Ayu) College Worli, Mumbai. Worli, Mumbai. level. ABSTRACT Gout is one of the commonest forms of arthritis becoming very common in India. Accumulation of toxins is the primary cause and pathogenesis of this condition. This fact is well accepted by Modern and Ayurveda. A male patient of age 50 years old came in OPD of Kayachikitsa department of M.A. Podar Hospital, Mumbai with complaints of bilateral knee joint pain, bilateral ankle joint pain and swelling treated with Kalbasti krama of Navakarshik Basti as said by Acharya Yogratnakar in Vatrakta Chikitsa Adhyaya but in decoction form as internal medicine. It shown remarkable result in joint pain and swelling as well as in serum uric acid level. Details is available in full article. KEYWORDS: Bilateral ankle joint pain and swelling (Vatrakta- Gout), Bilateral ankle joint pain, Navakarshik basti, Serum uric acid INTRODUCTION Excessive accumulation of uric acid leads to formation of small uric acid crystals which are deposited in the joints and causes recurring joint inflammation and pain. High blood uric acid levels could also lead to this condition without any history of pain. This condition is marked by fever and extremely painful joint inflammation with rapid onset. Panchkarma therapy is one of the most effective treatments in Vatrakta. Vatrakta is a combination of two words Vata and Rakta. There are three known synonyms of Vatrakta. They are Khuda, Adhyavata and Vol 6, Issue 2,

2 Vatabalasak. Khuda means small joints. Since in this disease, the small joints are inflicted it is called as Khuda Vata. Adhyavata means the rich class of people and those who are delicate. Since this class of people is generally inflicted with the disease. The aggrevated vata having been obstructed in its passage by aggrevated blood, affects the entire blood. Ayurvedic treatments for Vatrakta vary depending on the condition of the patient and severity of the disease. The treatment consists of Panchkarma, oral medication and diet ; so this case report is planned to evaluate the effect of Navkarshik Basti. MATERIALS AND METHOD A male patient of age 50years admitted in male Kayachikitsa ward of M. A. Podar Hospital, Worli, Mumbai 18. Name- A.B.C. (50yrs /male) DOA- 08/11/2016 OPD No.- E/ 5817 IPD No.- E/ 5817 Diagnosis Vatrakta [Gout] c/o Bilateral knee joint pain and swelling Bilateral ankle joint pain and swelling 1 week Cannot walk without support (Patient had pain during physical activities) X Ray B/L ankle joint Within normal limits. This patient was treated with Navakarshik Basti for 14 days. Materials Contents of the Navakarshik Basti 1) Daruharidra.(Berberis aristata) 2) Guduchi (Tinospora cordifolia) 3) Kutaki (Picrorhiza kurroa) 4) Vacha (Acorus calamus) 5) Manjishtha (Rubia cordifolia) 6) Nimba (Azadirachta indica) 7) Aamalkai (Emblica offincinale) 8) Haritaki (Terminalia chebula) 9) Bibhitak (Terminalia bellirica) 10) Til taila (Oil of Sesamum indicum) 11) Saindhava (type of a salt) Vol 6, Issue 2,

3 12) Madhu (Honey) Preparation of Basti Basti dravya will be mixed in the following order. Initially madhu and saindhava are to be mixed and then til tail will be mixed then kwatha of above mentioned dravya will be mixed properly [Charak siddhisthana 3/23]. All total 350 ml niruha basti given to the patient. Basti matra is decided accordingly dharanshakti (retaining property) of patient. Dose Anuvasan Til taila 60 ml Niruha ml Ratio - 1(Anuvasana) : 2 (Niruha) Duration Niruha had given on empty stomach and anuvasana basti had given after meal. Ratio of basti was 1:2,one anuvasan basti and two niruha basti as per more pachana expected. Table no.1: Properties of dravya Dravya Rasa Virya Vipaka Guna Doshghnata Daruharidra Tikta Kashaya Ushna Katu Laghu Ruksha Kaphghna Pittaghna Guduchi Tikta Kashaya Ushna Madhura Guru Snigdha Tridhoshar Kutaki Tikta Sheeta Katu Laghu Ruksha Kaphghna Pittaghna Vacha Katu Tikta Ushna Katu Laghu Tikshna Vataghna Kaphshamak Manjishtha Tikta Madhura Kashaya Ushna Katu Guru Ruksha Nimba Tikta Kashya Sheeta Katu Laghu Aamlaki Haritaki Amlapradhan (Pancharasa) Kashayapradhan (Panchrasa) Sheeta Madhur Guru Ruksha Sheeta Pittaghna Kaphghna Kaphashamak Pittashamak Tridhoshar Ushna Madhur Laghu Ruksha Tridhoshar Bibhitak Kashay Ushna Madhur Laghu Ruksha Tridhoshar (Kaphaghna) Saindhav Lavana Madhura Snigdha Tridoshaghna OBSERVATION AND RESULT CRITERIA FOR ASSESMENT 1) Pain 2) Joint tenderness Vol 6, Issue 2,

4 3) Swelling 4) Serum uric acid level Likert Scale: For gradation of pain. Tenderness Grade 0 No pain 1 mild pain 2 moderate pain 3 severe pain 4 extreme pain Grade 0 No tenderness 1 Patient feels pain on touch 2 Wincing of face. 3 Wincing of face and withdrawal of affecting part 4 Patient will not allow the joint to be touched Swelling Serum Uric Grade 0 No Swelling 1 Slight Swelling 2 Moderate Swelling 3 Severe Swelling Before treatment After treatment Interpretation of score Patient had following score, DISCUSSION Sr.no. Criterion Before Basti After Basti 1 Pain Tenderness Swelling Serum Uric acid Type of vatrakta in this study was Vatapradhan pitta along with raktadushti. All the contents used in the Navakarshik basti are raktadushtihar and tridoshar. Tightening of veins and joints, Vol 6, Issue 2,

5 inflexibility are due to Vatadushti. Inflammation with severe pain and sharp pain and swelling due to raktadushti. 1) By its properties Daruharidra is vedanasthapana, pittasarak and raktavahashodhak. 2) Guduchi is tridosh-shamak mentioned in Ayurvedic classical texrbooks.due to its tikta Kashaya rasa and madhura vipaka it is pittashamak and raktadushtihar. 3) Triphala used in the basti is tridoshar and its vipaka is madhura help is neutralising Pitta and Vatadushti. 4) Vacha is katu-tiktarasatmaka, ushnaviryatmaka, katuvipaki dravya, it mitigates vata and kapha dosha. 5) Nimba has Tikta rasa predominance which purifies blood and cures Raktjanya vyadhi as mentioned in Ayurvedic classical texrbooks. 6) All the contents has Tikta Rasa which detoxifies bacteria, germs & kills worms. It relieves fainting, burning sensation, itching, inflammatory skin conditions & thirst. Bitter taste creates lightness of the skin & muscles. It is antipyretic, enkindles digestive fire, promotes digestion of undigested toxins (ama), purifies lactation, helps scrape away fat & removes toxic accumulation in fat, marrow, lymph, sweat, urine, excrement, pitta & kapha. It is dry (Ruksha), cold (sita), & light (laghu). CONCLUSION Vatarakta (Gout) is a type of inflammatory disease in which Navakarshik basti is one of the best treatments than taking decoction of the same drug. The Navakarshik basti is much beneficial in the patient of Vatarakta (Gout) by relieving the local pain, swelling and tenderness as most of its contents are Vataghna, Vednasthapan and Shothahara Dravya and blood purifier which detoxify body. REFERENCES 1. Charaka Samhita of Agnivesa, Volume-II, Edited by Dr. Brahmanand Tripathi Foreword by Dr. Prabhakar J. Deshpande, Chaukhamba Surabharati Prakashan Varanasi, Edition p Charaka Samhita of Agnivesa, Volume-II, Edited by Dr. Brahmanand Tripathi Foreword by Dr. Prabhakar J. Deshpande, Chaukhamba Surabharati Prakashan Varanasi, Edition p Panchakarma Illustrated, Dr. G. Shrinivasa Acharya, Foreword by Prof. R. H. Singh, Chaukhamba Sanskrit Pratishthan Delhi, Reprint-2015, p Vol 6, Issue 2,

6 4. Charaka Samhita Volume I, Edited by Aacharya Vidhyadhar Shukla and Prof. Ravidutta Tripathi, Foreword by Acharya Priyavrata Sharma, Chaukhamba Sanskrita Pratishthan Delhi, Reprint-2007, p Panchakarma Illustrated, Dr. G. Shrinivasa Acharya, Foreword by Prof. R. H. Singh, Chaukhamba Sanskrit Pratishthan Delhi, Reprint-2015, p Charaka Samhita Volume I, Edited by Aacharya Vidhyadhar Shukla and Prof. Ravidutta Tripathi, Foreword by Acharya Priyavrata Sharma, Chaukhamba Sanskrita Pratishthan Delhi, Reprint-2007, p Dravyaguna Vijnana Volume-II, By Prof. P. V. Sharma, Chaukhamba Bharati Academy Varanasi, Reprint-2013, p Dravyaguna Vijnana Volume-II, By Prof. P. V. Sharma, Chaukhamba Bharati Academy Varanasi, Reprint-2013, p Dravyaguna Vijnana Volume-II, By Prof. P. V. Sharma, Chaukhamba Bharati Academy Varanasi, Reprint-2013, p Dravyaguna Vijnana Volume-II, By Prof. P. V. Sharma, Chaukhamba Bharati Academy Varanasi, Reprint-2013, p Yogratnakar vidhyotini Hindi, Vaidya Laxmipatishastri, Chaukhamba Sanskrit samsthana. Vol 6, Issue 2,